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PP: RNSG 1538 Family Mastery Quiz
Terms in this set (50)
"Dad has presented many challenges. We have alarms on all the outside doors now. Respite care gives us a break."
An elderly client with Alzheimer's disease has been living with his grown child's family for the past 6 months. He wanders at night and needs help with activities of daily living. Which statement by his child suggests that the family is successfully adjusting to this living arrangement?
Communication barriers between the mother and staff
The nurse is caring for a child whose mother is deaf and untrusting of staff. She frequently cries at the bedside, but refuses intervention from social work or the chaplain. Which issue is most important for the nurse to address with the mother to promote a trusting relationship?
Low-quality support relationships often negatively affect coping in a crisis.
A nurse is assessing available support systems for a client in the community mental health clinic. The client is divorced, has no siblings, and both parents died last year. The client has contact with once-supportive former in-laws; however, the client describes a strained relationship since the divorce. With regard to the relationship with the in-laws, what knowledge does the nurse use to plan care?
Abuse and neglect.
Unhealthy personal boundaries
The nurse is performing an assessment on a client with a history of a dysfunctional family. Which findings should the nurse anticipate? Select all that apply.
The mother looks at the newborn with direct eye contact.
The nurse brings the infant to the new mother after obtaining assessment data and performing newborn interventions. Which of the following behaviors exhibited by the mother demonstrates that effective bonding is beginning to take place?
"What aspect of caring for your husband is causing you the greatest concern?"
A man found wandering in a local park is unable to state who or where he is or where he lives. He is brought to the emergency department, where his identification is eventually discovered. The client's wife states that he was diagnosed with Alzheimer's disease 3 years earlier and has experienced increasing memory loss. She tells a nurse she is worried about how she'll continue to care for him. Which response by the nurse is most helpful?
Risk for caregiver role strain related to increased client care needs
A client with Alzheimer's disease is admitted for hip surgery after falling and fracturing the right hip. The client's spouse tells the nurse about feeling guilty for letting the accident happen and reports not sleeping well lately because the spouse has been getting up at night and doing odd things. Which nursing diagnosis is most appropriate for the client's spouse?
"You should bring your child to the emergency department tonight so the bead can be removed as soon as possible."
The father of a 2-year-old phones the emergency department on a Sunday night and informs the nurse that his son put a bead in his nose. What is the most appropriate recommendation by the nurse?
Practice deep breathing and muscle relaxation.
A client is experiencing considerable stress in a change of role from married to divorced. The client states that the in-laws blame the client's drinking for the divorce. The client states that, "These days, a couple of glasses of wine in the evenings helps calm my nerves." What is the best coping strategy for the nurse to offer the client?
Ensure the comfort and security of the client and meet privately with the family member.
After being informed that a client is to be admitted to the hospital for stabilization of the client's diabetes, the client's son returns to the hospital six hours later to find that the client remains on a stretcher in the emergency department hallway. He begins to shout "I will not allow my insurance to pay for your failure to provide care." What is the best action for the nurse to take in this situation?
The parents will call immediate attention to undesirable behavior.
Which desired outcome demonstrates effective parent teaching about disciplining a toddler?
"I understand your concern; you may want to start your daughter on long-acting contraception."
The mother of a 17-year-old girl with Down syndrome tells the nurse that her daughter recently stated that she has a boyfriend. The mother is concerned that her daughter might become pregnant. Which is the most appropriate suggestion by the nurse?
Caregiver role strain related to the demands of the child's care
A home care nurse is visiting a family with a chronically ill 9-year-old child. Which of the following is a priority nursing diagnosis when working with a family caring for their chronically ill child at home?
"Opioids are avoided following a head injury because they may hide a deteriorating condition."
19 year old male with mild concussion after slipping in school parking lot three hours prior. No loss of consciousness. No appreciable neurological deficits. CT scan normal. Client was preparing for discharge. Now reports a 5/10 headache. Acetaminophen PO ordered.
When offered acetaminophen, the client's mother tells the nurse that she would like her son to have something stronger. What is the nurse's best response?
Address how the substance use has effected each member of the family
A young adult client who uses cannabis multiple times a day, has just participated in a family meeting at a community mental health center. The chart entry reads:
The family meeting began by the client's family demanding that the client "stop using marijuana at once, or there will be severe consequences, including no support to attend college." The drug, and the problems associated with its use, were explained to the family.
What educational topic should the nurse address with this family during the next teaching session?
"My baby will be fine soon after we are home."
A newborn is diagnosed with fetal alcohol syndrome. The nurse is teaching this mother what to expect when she goes home with her baby. The nurse determines the mother needs further instruction when she makes which statement?
A client with multiple sclerosis (MS) lives with her daughter and 3-year-old granddaughter. The daughter asks the nurse what she can do at home to help her mother. Which measure would be most beneficial?
Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.
An 18-month-old with a congenital heart defect is to receive digoxin twice a day. Which instructions should the nurse give the parents?
Ask the client to identify who is considered family.
A nurse wants to ensure inclusiveness in language regarding family when developing a plan of care for a client. Which of the following is the most important action for the nurse to take to ensure that the plan is inclusive?
Use active listening and silence when communicating.
A nurse is working with a dying client and the client's family. Which communication technique is most important to use?
"You seem to have some feelings about hitting your wife."
A client ashamedly tells the nurse that he hit his wife while intoxicated and asks the nurse if his wife will ever forgive him. The nurse should reply to the client by saying:
Provide stimulating, nonthreatening life experiences.
The nurse discusses with the parents how best to raise the IQ of their child with Down syndrome. Which intervention would be most appropriate?
Convey warmth and acceptance to each family member.
When working with a client who has a mental illness and the client's family, which approach will be most effective?
Which goal is a priority after surgical repair of a cleft lip?
"We can see you without your parents' consent but have to report any positive results to the public health department."
A 17-year-old high school senior calls the clinic because she thinks she might have gonorrhea. She wants to be seen but wants assurances that no one will know. Which is the most appropriate response by the nurse?
Promoting the nurse's personal values and beliefs if she considers the family's to be inappropriate
When attempting to facilitate spiritual support for a school-age child with a life-threatening disease and his family, which action would hinder the nurse-client relationship?
"Consistently reward positive behavior and reinforce consequences of negative behavior."
When doing discharge planning for a hospitalized client with impulse control disorder, a nurse explains how family members can participate effectively in the client's ongoing care. What instruction should the nurse include?
Record the father's story in the medical record.
A 4-year-old boy presents to the emergency department. His father tearfully reports that he was in the driveway and had his son on his shoulders when the child began to fall. The father grabbed him by the leg, swinging him toward the grass to avoid landing on the pavement. As the father swung his son, the child hit his head on the driveway and twisted his right leg. After a complete examination, it is determined that the child has a skull fracture and a spiral fracture of the femur. What action should the nurse take?
A child reports of constant hunger.
The school nurse is conducting health assessments for a group of children. Which of the following situations encountered by the nurse raises suspicion of child neglect?
Unhealthy personal boundaries.
Abuse and neglect
The nurse is performing an assessment on a client with a history of a dysfunctional family. Which findings should the nurse anticipate? Select all that apply.
People whom the client views as family.
People who provide for the physical and emotional needs of the client.
A nurse is assessing a newly admitted client's support system. In documenting the family assessment, who should be considered as part of the client's family? Select all that apply.
The child should stay on penicillin and return for a follow-up appointment.
A school-age child is being discharged with a diagnosis of rheumatic fever. Which instructions should be included in the teaching plan for the family?
"The transplant coordinator can give you information about the donor's medical history."
The recipient of a donated organ asks the nurse, "What did the donor die from?" Which response by the nurse is most appropriate?
Describe each of the potential causes and possible treatment modalities.
A couple visiting the infertility clinic for the first time states that they have been trying to conceive for the past 2 years without success. After a history and physical examination of both partners, what would be the most appropriate outcome for the couple to accomplish by the end of this visit?
Ask the family to identify a spokesperson to be the communicator with the team.
The nurse is caring for a very ill child with a large extended family. Members of the family repeatedly ask the same questions of the nurse and other healthcare team members. To effectively manage the accurate dissemination of information, which of the following should be the priority action by the nurse?
The taking-hold phase
During the second day postpartum, the nurse notices that a client is initiating breastfeeding with her infant and changing her infant's diapers with a little assistance from her partner. According to Reva Rubin's "phases of bonding," which of the following is the appropriate phase the woman is experiencing?
inform the parents of risks and treatment of alcohol poisoning.
During a visit home after a teenager's first semester at college, a client is admitted for acute alcohol poisoning. The client's parents report that there is no alcohol in their home. The priority intervention for the nurse caring for this family is to:
Talk with the client's family about the client's right to decide for himself.
A nurse is caring for a client with advanced heart failure. He can't care for himself and hasn't been able to eat for the past week because of dyspnea. The client doesn't want a feeding tube inserted and expresses his desire for "nature to take its course." The client's family is pleading with him to have a feeding tube inserted. What is the most appropriate action for the nurse to take?
"Your child was diagnosed as having ADHD because of her attention and behavior problems at school."
"ADHD involves difficulty with attention, impulse control, and hyperactivity at school, home, or in both settings."
"Your provider is considering a bipolar diagnosis because of your child's family history of bipolar disorder and her sleep issues."
A young school-age girl whose mother and aunt have been diagnosed as having bipolar disorder and whose father is diagnosed with depression is brought to the clinic because of problems with behavior and attention in school and inability to sleep at night. The child says, "My brain does not turn off at night." The child is diagnosed as experiencing attention deficit hyperactivity disorder (ADHD) with a possibility of bipolar disorder as well. What should the nurse say to the father to explain what the provider said? Select all that apply.
Keep the child safe and assess for abuse.
The nurse is caring for a 5-year-old child who has a history of multiple admissions for fractures and cuts. The mother explains that the child fractured the femur by falling, but does not give any further details. The child indicates that the mother's boyfriend was present when the injury occurred, and the child's recollection of the event conflicts with the mother's explanation. What is the nurse's immediate responsibility?
recognize their request and respectfully take corrective action.
The Orthodox Jewish family of a client admitted for cochlear implantation expresses outrage at their child being served a pork dish after they identified their religion to the nursing staff. The best response of the nurse would be to:
Impaired parenting related to the neonate's transfer to the intensive care unit
A client with Rh isoimmunization gives birth to a neonate with an enlarged heart and severe, generalized edema. The neonate is immediately transferred to the neonatal intensive care unit. Which nursing diagnosis is most appropriate for the client?
"Your child will need less blood work as his glucose levels stabilize."
A physician orders blood glucose levels every 4 hours for a 4-year-old child with brittle type 1 diabetes. The parents are worried that drawing so much blood will traumatize their child. How can the nurse best reassure the parents?
The son of an older adult reports that his father increasingly just "stares off into space" in the last several months, but then eagerly smiles and nods once the son can get his attention. The nurse should assess the client further for:
The client will be placed on withdrawal precautions and treatment started immediately.
A prescription should be obtained to help with the hallucinations.
The client's medical and mental status will be evaluated frequently and treated as needed.
An elderly client hospitalized 4 days ago for treatment of acute respiratory distress has become confused and disoriented. The client has been picking invisible items off blankets and has been yelling at the daughter who is not in the room. The family tells the nurse that the client has been treated for anxiety with alprazolam for years, but alprazolam is not on the current medication list. Which safety measures should be implemented? Select all that apply.
How is your condition affecting your family members and their usual roles?
What question would the nurse ask to assess coping abilities of a family dealing with a chronic illness?
potential suicidal thoughts/plans of both family members
A school nurse interviews the parent of a middle school student who is exhibiting behavioral problem, including substance abuse, following a sibling's suicide. The parent says "I am a single parent who has to work hard to support my family, and now I have lost my only son and my daughter is acting out and making me crazy! I just cannot take all this stress!" Which concern regarding this family has top priority at this time?
whether the toddler is experiencing changes in the home environment
A mother brings her 18-month-old child to the clinic because the child eats ashes, crayons, and paper. Which information would be most important to obtain about this toddler?
vocalizing single syllables
The parent of a 9-month-old expressed concern that the baby "is developing slowly." The nurse is concerned about a developmental delay when finding the baby is unable to accomplish which skill?
Show the client how the baby initiates interaction with her and attends to her.
The client is a 17-year-old single mother who has given birth. On her first postpartum day, the client seems overwhelmed with her new baby and asks the nurse how she is supposed to interact with her baby when all the baby does is eat and sleep. Which of the following actions would be most effective for the nurse to use to facilitate mother-infant attachment?
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